#EAPM - Politics, people and health care across the spectrum

The European Parliament elections are peeping over the horizon - they’ll take place towards the end of May - and, quite rightly, a lot of sitting MEPs and aspiring occupiers of seats in Brussels and Strasbourg are starting to talk about health care, writes European Alliance for Personalised Medicine (EAPM) Executive Director Denis Horgan.    

Of course, the topic is always high on the public’s agenda. Not least in cancer which, by the way, is being highlighted once again by World Cancer Day (today, Monday 4 February). Given that we obviously don’t know the make-up of the new Parliament just yet, we do know that it will come from a political rainbow of the left, the right, and the centre - with Eurosceptics and environmentalists also in the mix.

So maybe it’s time to take a quick look at how those of each political hue will focus on health care.     Taking the National Health Service (NHS) in the UK - a Labour post-war creation - as an example, socialists tend to look at providing universal health care for all on the basis of need, free at the point of use.

This is paid for, of course, by taxes and national insurance contributions and relies on enough healthy people working to pay for it. This is a struggle at the moment, due to the ageing population and the rise in co-morbidities (although these factors obviously affect every government).

The UK’s Labour party cites the creation of the NHS as its “proudest achievement” and is looking to give patients the modern, well-resourced services they need for the 21st century, coupled with the world-class quality of care they need and staff who are able to deliver the standards that patients expect.

It talks about ‘properly resourcing’ the healthcare system and stopping what it calls ‘the routine breach of safe levels of bed occupancy’. All left-of-centre governments talk big about focusing resources on services to provide care closer to home, plus new models of community care that take into account primary care and also social care and mental health.

An issue that remains for all healthcare providers, of course, is the growing problem of rationing of services and medicines and ‘postcode lotteries’, which means that the quality of care received by a patient does not depend on which part of the country they live in.  Or in fact, which country they live in. This nods to cross-border healthcare which, of course, has cross-party support.

Those on the right, meanwhile, or at least right-of-centre, tend to look towards to market forces, especially in cases where the capitalist class is strong while the labour force is less so.      These countries tend to have, or at least dream of, lower public expenditures on healthcare, with the private sector being important in providing welfare services.

It’s safe to say that there is a lot of income inequality in the EU. But unlike the other nations, the social democratic countries tend to be more committed to welfare-state expansion, full employment policies and a higher percentage of women in the labour force. These are the lesser priorities of the parties on the right who, as suggested, want the state to be ‘smaller’, and tend to encourage private participation in healthcare where possible.

It is fair to say that the current European Parliament, for example, has a clear democratically elected majority among member states (Liberals, Conservatives, and Christian Democrats), which explains why its policies tend to the right in the main. Policies and priorities on the right can include increasing resources to front-line healthcare workers, strengthen the focus on excellence in research, discovery, innovative service delivery and patient-centred problem-solving. Usually through public/private means, or sometimes simply private.

And many on the right believe that, rather than health care being centralized, the regions within a member state should take responsibility for health-care funding and management and be fully accountable for the results.

Centrists tend to take up a combination of the two and, as do all sides of the political spectrum, look for best practices, while protecting the principle that reaching fora credit card to pay for care should be kept to a minimum. The liberal model does put an emphasis on the responsibility of individuals, and yet some lesser-or-greater degree of social protection is afforded to the less well-off, complemented by company or private insurance.  The state in this case tends to encourage the private sector to help provide services, and there is an option to go for public and/or private providers. Ireland is a good example, here. Whichever model is used, though, from the left, right or centre, all politicians have a duty to protect and enhance public health under whatever form their party-political leanings take.

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